My name is Matt and I’m True North ITG’s CEO and CISO, meaning, I’m also in charge of security here at True North.

Healthcare and Cloud Computing

Interviewer:

Thanks, Matt.

So, today we will be talking about a number of different topics, all of which are related to the healthcare industry and cloud deployment. Topics include: cloud computing and its advantages and disadvantages; what should be on your radar; and how you should start deploying cloud, if you haven’t already as well as some things to keep in mind.

The first topic that I want to ask you about is:

What are the use cases for cloud computing in healthcare?

There are many trends happening around cloud computing, including a huge push toward cloud. But there’s also a lot of ambiguity regarding the tools and apps that a healthcare organization should starting to move towards cloud.

Can you speak to some of those trends and the platforms for healthcare in cloud computing?

Absolutely. So, the number one application that we see, which is pretty typical, is email.

eMail in the Cloud

If you look at cloud adoption, email’s right up there in the 80% range. So it’s a very common for most organizations in healthcare moving to the cloud.

EHR in the Cloud

Following email, we’re certainly seeing more electronic medical records being moved to the cloud. But we notice from most is that this move is towards a hybrid cloud configuration.

So the actual core database and main electronic health record application is moved to the cloud, and that environment is then connected to either an on-premise environment or another cloud provider that may provide services like PACS (picture archiving and communication system) imaging, interfaces, interoperability between hospitals or other practices.

Fax in the Cloud

Faxing is still used in a lot of organizations, they still have their fax environment on-premise. We’re starting to see organizations move core applications, it’s certainly moving faster than we’ve seen it before, but still gaining ground.

Interviewer:

At a high level,

How do you see cloud deployed across healthcare organizations in the United States?

Matt Murren:

Healthcare Cloud Integration

Within cloud in healthcare, unlike the financial or legal industries, there’s not a lot of integration points to other systems that depend heavily on transferring transactions.

When you go to the physician and they place an order for a prescription or x-ray, all of those systems have to interconnect to a secondary or even tertiary system that may be their system or even a system at another location.

Hybrid Cloud in Healthcare

Due to that, it falls back to the hybrid model where the core cloud environment is either private or managed private (which just simply means that they have full access and control, but the environment is managed by a provider like True North). Then, as you move towards larger hospitals, you start seeing public cloud implementations, but many of those are still in a hybrid configuration.

Even though they may be using Azure or Amazon Web Services (AWS), a lot of those still are not 100% offsite cloud-hosted infrastructure. Moreover, I don’t see that model changing until some of the ancillary and third-party applications have more interoperability between the different cloud architectures.

Give your doctors the speed and reliability of cloud based Healthcare IT.

Large Healthcare Companies and Cloud Healthcare Investments

What’s really interesting to me is – as you were saying – larger healthcare organizations are much likelier to be using public cloud distribution.

Why are larger healthcare organizations using public cloud more often?

Matt Murren:

When I say larger, I’m referring to 5,000 to 10,000 employees or more.

There are a couple components.

First: scale. The smaller you are, the less scale you get on density and pricing. But once these start crossing 5,000 or 10,000 employees, the return-on-investment (ROI) scale supports the public cloud distribution model better than it does sub-5,000 employees or seats. So it would be the same as if you bought hardware on-premise. The more scale you have in your system, the higher your ROI is.

Second: marketing. Azure, and AWS have done a good job marketing to the executives at those larger healthcare institutions. There are also volume-type arrangements where reaching a certain size also drives that price down.

Key Drivers of Hybrid Cloud in the Healthcare Industry

What areas of healthcare are the the most behind in terms of cloud-deployment?

Matt Murren:

Systems that are Still On-Prem in Healthcare

If you break the different components down in a healthcare organization in terms of data, certainly, financial systems and imaging systems are typically ones we still see on-premise. I’d also include faxing systems as a lot of interfaces are also typically ran on-premise,

But there isn’t a one-size-fits-all model. Because it depends on a few different things, such as:

What’s the current architecture?

How does that map in terms of the lifecycle of the software?

What’s the life cycle of the hardware?

And others.

There are a lot of considerations you have to account for and I haven’t really seen organizations all do it the same way. In each case, there are different drivers involved. Sometimes, there are no drivers but simply a time issue where organization hasn’t actually gotten to migrating offsite and into the cloud yet.

Interviewer:

So, in essence, there’s really no reason that an organization would, for example, want to have their imaging systems fully on-premise other than the fact that they just haven’t got to moving to the cloud or they have some inherent apprehension towards moving to the cloud?

Matt Murren:

Yes. There are still a lot of legacy platforms that run Unix. There’s still some mainframe out there. I know I’ve brought-up faxing, but that’s tied to analog phone-lines (those still exist).

Again, there are different drivers. So, if you take a service like Azure, and say, ‘I want to move this AS/400 into a rack in Azure’, you’re not going to be able to do that.

How to get a legacy healthcare system into the cloud

At True North, we provide customer racks for that purpose – i.e. accommodate the benefits of offsite colocation, but also integrating that into a cloud environment. So, that’s just something unique that we do and driven by what we see in some of those areas.

That’s really interesting. So, essentially, what you’re saying is that there are some legacy platforms that are built in such a way that they can’t be moved into any kind of a public cloud environment. But you could still have it in an offsite, cloud-based system as long as it was a dedicated hardware platform that was designed or architected specifically for that?

Matt Murren:

Exactly. Let’s say someone has a very low-end server room and they want to move that to a more secure location with better environmental controls, more power redundancy and more physical controls around it. There’s some planning required, but we can put those servers in a collocated rack and securely connect them to the virtualized cloud environment so that it’s an extension of their environment.

There’s no ‘one-size-fits-all’ approach to how healthcare is moving to the cloud, especially as every hospital has its own unique circumstances and issues. Contact us today to explore how we can build a custom system tailored to your needs.

In part-two, Matt examines the advantages and disadvantages of using cloud for electronic health records (EHR).

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